6 weeks under our belt

Today is officially the 6 week mark since Heidi's meniscus removal. Last time I checked in with you guys, I was a little concerned that she was still limping but was hopeful that it could take up to 6 weeks for the limp to go away. In the past week or 2 I have really noticed improvements. I think I mentioned before that Heidi's limp would worsen after our therapy walks. After a couple weeks of intermittent limping, I decided to rest her for a week. That apparently did the trick! Much to her disapproval, we reverted back to "outside for bathroom breaks only" for a week, and when we started her walks back up, there was a drastic improvement. She barely limps now and is much like she was BEFORE the meniscal tear. If you can remember back, she never fully recovered after the MMP surgery. When standing still she would favor that leg slightly and maybe had a barely noticeable hitch in her step. I'd say we're back there now and I am thrilled. We are about to bump her walks up to 20 minutes and we're still going to take it slow and not allow her to be TOO wild, but I definitely feel like we're back on track and I am pleased with her recovery. My parents, who see her every couple of weeks, said they noticed a huge difference on her last visit and I'd say it's only gotten better since then. So the lesson here is one of PATIENCE! I also think the rest really helped her, so although that wasn't what the vet originally suggested, remember sometimes you may need to alter "the plan" a little to do what you think is best for your dog :)

Week 1 of Rehab Walks Down

Alright, so this whole weekly update thing is not my forte this go around. I blame it on school. It's consuming my life! BUT, back to business, Heidi is still doing well, although we had a super small scare. Two Monday's ago, right after my last post, I came home from work and Heidi's incision was really really red and raw. She still had her stitches in and they seemed to be bothering her. I think the redness/rawness was from her licking them, so Alex and I decided to go ahead and take them out. It was day 11 post-op so it was within that 14 day window and I could tell the incision itself was closed. She would not let me touch that area so it made the suture removal pretty difficult. I forced my husband to hold her down (He HATES having to do that to his "baby") and I was finally able to get them all out after a huge struggle. I rinsed the area really well before and after with a disinfectant solution (Nolvasan) I got from the vet at another visit just as a precaution in case the redness was the beginnings of an infection, and decided to watch it closely for the next few days before panicking. I monitored her constantly for signs and symptoms of infection (increased redness, swelling, heat from the incision, smelly yellow drainage/pus), and luckily over the next few days the redness decreased and my worries slowly disappeared. Also, in the last post I talked about how crazy her knee looked because that one part was very swollen. Well, the swelling has gone down A LOT at this point and looks fairly normal (for a knee that has been through 3 surgeries)! I am a little disappointed because Heidi is still favoring that leg. We started her 5 minute rehab walks this week and they actually seem to make her limp slightly worse. At the same time, she LOVES her walks, so I don't want to stop. Next week we start 10 minute walks, so we'll see how that goes. I am just hoping this surgery will take a little longer to recover from since they took cartilage out of her knee. Like I mentioned before, something I read said to expect the dog to limp for 4-6 weeks and yesterday was the end of week 3. Thinking about that makes me feel a little better. We're only halfway through that time frame and she has made vast improvements. I can only hope it will continue. Send positive thoughts our way for the next few weeks and I'll try to update when I can!

1 Week Post-Op

It's technically been a week and 3 days since surgery, but who's counting? In my last post I was concerned that Heidi was mostly holding up her leg and walking on 3 legs, but that has gotten much better since then. She now always walks on all fours. She still has a limp, but I read on some vet website that the limping was expected for 4-6 weeks, so that made me feel better. Several days ago, she was using her leg a good bit, but when standing still, she would just barely touch it to the ground, oftentimes just resting the top of her foot on the ground with the toes curled under, if you can picture that. Today I was taking a good look at her and realized she is now putting some weight on that foot when standing still, so that's a definite improvement. She is also VERY energetic. For probably the first 3 days she was very quiet, but now she is back to her old self and then some! It's hard to keep her quiet. She can be quite wild at times, especially when we come home from work. I just have to sit on the floor and pet her to make her settle. Otherwise she would be running around in circles and that's not good! We carried her up and down the steps for probably the first week, but have stopped now. It's not like her bone is healing, she just had a piece of cartilage removed. It's HARD for me to carry a 74lb dog up and down the stairs safely. I mean, that's more than half my weight! I was always scared I would fall, so I'm glad we decided that wasn't necessary. Her stitches come out sometime between Monday and Thursday. I like to wait closer to the 14 day mark, but if she starts messing with them before then, I'll take them out earlier in the 10-14 day range. Other than that, I don't have much to say. She's doing well, and I hope she will continue to limp less and less and gain back that muscle mass in her left leg. Poor thing is so scrawny compared to her "Hulk"-like right leg. I'll try to snap a picture at some point because it's funny. Anywho, I'm off to enjoy this gorgeous day- 71 and sunny! I'll take it! Check back soon for an update :)

Postop Day 2

Heidi finally got home around 7 yesterday evening. I think it's safe to say we were both very excited to see each other (I hadn't seen her since Wednesday morning before school). She was still pretty groggy from the meds and slept most of the evening. I was disappointed to see her mostly holding up her operative leg. I think it's totally expected, but after all of her other surgeries she has used her leg from the get go so I wasn't really expecting it for her. I will say she does use the leg a little if we force her to go slow. Especially if she's out on the grass or soft ground. This morning we got a wake-up call from the vet school at 7am... on a Saturday! They wanted to see how Heidi was doing. I was like, "well, she's still sleeping so I don't really know yet!" After that, we got up and went outside and ate breakfast. While outside, Heidi used her leg more than she did last night, so that was reassuring. She is on the same medications as before: tramadol and Rimadyl for pain and inflammation. She still seems pretty exhausted, as she has been sleeping all morning. We have blocked off the same area as before to keep her quiet. Her recovery is much shorter with this surgery, but we still want to do it right. Her mobility is supposed to be really restricted for the first 2 weeks, then after that she can begin short walks, increasing in length for the next 2-4 weeks. After that (fingers crossed) she will be back to normal. I will try to do frequent updates, especially to document the progression of her limp so check back in a few days!

Surgery #4

The hubs had to take Heidi to NC State yesterday for her appointment without me because I had clinical (I'm in nursing school for those of you who don't know) and I could not miss it. It KILLED me not to be there. I sent him on his way yesterday morning with a list- like an actual sheet of paper.. ok THREE sheets of paper- of questions and a list of meds Heidi is on currently. Seriously, I am probably the craziest dog-mom they've ever seen, but whatevs! I love my girl. They did X-rays and decided there was no infection!!! Best. news. ever. So she's in surgery today for a Meniscectomy (meniscus removal). She should actually be out by now, but we haven't heard from them yet. No news is good news, right? I'm so anxious to hear how my babe is doing, but I'm trying to be patient. More to come about how it went in a day or so. We pick her up tomorrow!!!

Quick Update

In the time between now and the last post, I made an appointment for Heidi on September 4th at the NCSU Vet School. I had to take Heidi to our local vet a couple of weeks ago because she began getting a swollen, red lump on her incision line just like last time. It was lower on the incision line than before, but they did a culture and it was infected. She was on antibiotics and it cleared up quickly, but the vet we spoke with at NC State is afraid these abscesses are being caused by an infection on the inside. I hope and pray they're wrong. Before that, though, as I posted before she was having the lameness and clicking associated with a meniscal tear, so strangely enough, that is what I'm hoping for. If it is indeed an infection of the implant, they will have to remove the remaining hardware, which is a porous titanium wedge (that her bone has now grown INTO). I don't really know what they do then to stabilize the knee/leg and apparently the recovery is AWFUL. So yeah, I'm really hoping that's not it. Well, I just wanted to do a follow-up post to let you know the latest, and you can expect another post in the near future in regards to her appointment on the 4th! Until then, send happy thoughts our way!

Torn... literally... again...

My poor Heidi girl can't catch a break.  A couple of weeks ago she began limping AGAIN.  It was minor and would kind of come and go, so honestly, the hubs and I tried to ignore it.  We decided no walks, just outside to potty, and that was it.  We were so hoping it was just a fluke (even though in the back of my mind I knew it wasn't.)  A couple of days ago, for the first time, I heard her knee popping.  I could just rip my hair out; I feel so defeated.  We seriously have tried to do everything right.  No more dog park.  No more rough play.  No more running.  Just controlled walks and lots of love.  I don't even know what brought this along- which is the worst part.  Just one night, she got out of her bed and was barely using her left back leg.  If you're not familiar with the progression of these knee injuries, often the next thing to go after a CCL tear is the meniscus.  The telltale sign is the knee click (popping). 

I need to call the vet school and make an appointment for her to be seen, but I already know what they will say- another knee surgery.  Her FOURTH knee surgery (third on that knee).  So I've put it off.  I will do it tomorrow.  Ugh. 

I know I'm getting ahead of myself, as I don't have all of the options or facts, but I'm really torn about the meniscus repair/removal surgery.  For those of you who don't know, the meniscus is a cartilaginous structure inside the knee.  It cushions the knee and helps provide stability to the joint.  With a torn meniscus it causes pain and instability... and leads to arthritis.  Without it, I imagine it may eventually cause pain and instability due to... dun dun dun... arthritis.  Well, maybe they'll only take out the damaged part of the meniscus.  But then does that leave her susceptible (or maybe even more susceptible) to future tears, leading to future surgeries?  I need to write these questions down to ask her doctor. 

I read somewhere that surgeons only think of the short-term.  If she has this surgery, she will be fixed.  But is it a permanent fix or just temporary?  In another 6 months will we be at this same place again?  My dog is only 3 years old!  I want to know where I can realistically expect Heidi to be when she's 10.  By God this dog will live past 10!  She's a shelter dog for Heaven's sake... a MUTT!  Aren't they supposed to be the best dogs?  I have a minor in genetics... a broader gene pool is supposed to provide enough variance to prevent genetic conditions, so WHY does my dog have a "genetic" degenerative joint condition????

Alright, time to put on my big girl panties.  I apologize for my pity party.  It's not really for me.  It's for Heidi.  She is the best dog.  She does not deserve any of this.  But I guess we'll take the hand we're dealt and do what we have to do.   That is all for now- I'll keep you all posted!

Side note:  If anyone reading this has had a dog with a torn meniscus, I would love to hear your story.  I haven't been able to find much online.

Some good news for a change :)

Earlier this week, the vet school called to let us know that they would be calling in an antibiotic for Heidi because some bacteria grew on her cultures.  I was very excited to learn that it only grew on the tissue and wire cultures.  No bacteria on the pin!!!!  That is what we were hoping for, because the pin actually entered the bone, and bone infections can be reeeeeeally bad.  The wire and the soft tissue, of course, were on the outside of the bone.  I am really hoping and praying that this last surgery and antibiotic fixes all of Heidi's problems, and she can get back to being a (fairly) normal dog!

Can someone send some GOOD luck our way!?!?

Well, the inevitable has happened.  The lump on Heidi's knee returned and we just brought her home from the vet school after having her THIRD surgery.  Mind you, my poor girl is not even 3 years old yet!  As the vet suspected, the irritation being caused by the wire from her MMP surgery was not a one time fluke.  We went to the lake for Memorial Day and Heidi went for a swim (her first time actually swimming willingly!) and the knot reappeared.  I called the vet school on Tuesday and they got her in today, Friday.  It was a fairly simple procedure- basically they removed the wire and the pin from the MMP surgery, but left the porous titanium wedge in place as there was no sign it was infected.  The pin and wire aren't actually needed now that her leg has healed, however it is usually not necessary to go back in and remove them because they typically don't cause problems.  Of course, that's not the case for our girl.  They took a tissue sample for culture and also cultured the wire and the pin.  We should know by Tuesday or Wednesday whether or not there's an infection brewing in there and she may need antibiotics.  We are hoping and praying that if it is an infection it's just in the tissue and not in the bone/wedge.  The vet said usually if an implant is infected, the bone sort of separates from the implant which can be seen in an X-ray or during surgery.  Hers did not have any type of space as far as they can tell, so that's a point on the positive side.  We do NOT want to have to remove the wedge so hopefully all of you Heidi fans can send any spare luck our way. 

Heidi is doing great since surgery.  They actually let me pick her up today, which was surprising because I was initially told she'd have to stay overnight.  I was thrilled to say the least (until I had to swipe the plastic, ouch!).  Right now, she is sleeping on her bed beside me.  They said she may limp because her leg would probably be a little painful, but in typical Heidi fashion, she is exceeding the expectations and she isn't limping at all!  I have Tramadol and Rimadyl to give her for a few days to help with pain and inflammation, but so far she's doing really really well.  Just groggy and a little nervous/paranoid acting. 

As always, I'll keep you updated if anything changes and will let you know the results of the cultures.  In the mean time please, please, please cross your fingers for good news next week!

Say it ain't so...

Well, it has been a long time since I've updated the blog, but we've had some changes since my last post.  In early January we let Heidi play out in a yard leash-free for the first time since surgery.  She probably overdid it a little, and the next day we noticed a little swollen lump on her incision line (her knee that was done in July- the MMP surgery).  It was kind of hard, kind of squishy- weird I know.  After a few days of rest, the swelling went down and we went along our business.  A few more times we let Heidi have some off leash activity and each time, this little knot would appear the next day.  More recently, I've noticed this knot is always there.  It swells with excessive activity, but never goes completely away.  Finally, maybe the end of February we took her to our local vet to get it checked out.  They did not think it was anything too serious, but were afraid to do anything to it since they had not performed the surgery, and recommended we see the doctor who did the surgery.  So after much deliberation, Alex and I made the appointment.  Last Thursday night I came home from clinical and the knot/lump had burst (no idea how or why).  It was bleeding slightly, but that was about it- no pus or yucky discharge.  Luckily, our vet appointment was set for the following Monday (yesterday) so over the weekend I kept it covered with gauze and tape and flushed it daily with sterile saline.

Fast-forward to yesterday, the day of the appointment at the vet school.  I took off work and to Raleigh we went.  We had X-rays and obtained a culture of the wound.  The vets think the knot was probably caused by the tiny wire that held the implant in place.  (If you look back at one of my previous posts, probably around July of 2012, there are X-rays of the procedure she had and you can see what wire I'm talking about).  Apparently some dogs are super sensitive and the tiny ends of the wire can irritate the tissue in that area.  This irritated, inflamed area then probably developed an infection- we will know more about that when the culture comes back (by Friday).  They started her on a broad spectrum antibiotic, Clindamycin 300 mg every 12 hours, and once they find out if it is a bacterial infection and what type, they will prescribe her something more specific.  In the mean time I am cleaning her wound with a chlorohexidine solution they gave me, applying triple antibiotic ointment, and covering it with a gauze bandage.  I chose to go this route for now, until the culture comes back.  They really encouraged me to do the surgery to remove the wire, but I wanted to see what "bug" was in her, causing this mess before making that decision.  There is a small chance it could just be an inflammatory response with no infection, but they seem to think this is unlikely.  Our greatest risk here is that the actual implant (wedge shaped foam-like piece between 2 pieces of her bone) or her bone could become infected.  That is a very serious problem and would likely require removal of all of the hardware in her leg, which would leave her at a high risk for injury.  That would require another 8 weeks of total confinement to allow the empty space to fill with bone and would be very very tough on both Heidi and us.  So we of course are trying to avoid that at all cost, but I also just want to make sure there is an infection in the first place before jumping to more surgery. 

My poor girl has been through it, but she is a trooper.  Just to add my two cents, if I could do this all over again with her second knee, I would've done the TTO procedure like we did with the first knee.  Knowing what I know now, I think if you do get in a situation where the implant is infected, it is MUCH easier to remove the hardware and much less traumatic to the poor pup who endures the procedure with the TTO. Yeah, the MMP was a few hundred dollars cheaper and she was under anesthesia for a shorter amount of time, but the possible complications seem less extreme with the TTO.  Just thought I'd put that out there in case anyone is toying with a decision between those two surgical procedures.  As always, I will keep you guys updated as often as I can.  Should know more by Friday.  In the mean time, keep us in your thoughts!

Been a while...

Well, it has been way too long since a post, but I was just watching Heidi walk around today and thought I should give an update.  She is doing great and I think still improving.  It's been about 3 and a half months since her last surgery.  Last time I posted, I was still a little concerned about the fact that she still did not bear as much weight on her left leg (the one we did the MMP surgery on in July).  The hubs and I were kind of wishing we had just stuck with the TTO like we did for her first knee.  I was convinced the MMP just did not give her the stability she got with the TTO, (which may be the case but it's hard to know).  However, little by little I feel like she is putting more weight on the left leg.  It's like it just took her a while to really trust that leg.  We've also ramped up her activity a good bit over the last month or so.  She now gets to play off leash for short periods of time, although she has not played off leash with other dogs.  I think we're ready to try one on one time with another dog, so hopefully we'll get a chance to let her do that in the next couple of weeks.  Well I'll keep you guys updated!  I hope you've enjoyed reading about Heidi's journey through 2 CCL tears. 

6 weeks post-op

Well today we are 6 weeks post-op!  Sorry I missed our 5 week check-in... I just started school this week and was distracted by all the preparations of being a student again, but that's a story for another day.  Today we actually begin going on 20 minute walks.  Heidi has thoroughly enjoyed her 10 minute walks and will love our even longer ones I'm sure.  As far as her limp goes, it's only barely noticeable, yay!  She still does not evenly distribute her weight between her two back legs while standing still, but slowly she seems to be balancing it out more and more.  I think these rehab walks are helping with that because there was such a difference in muscle mass between the two legs and now we're beginning to build that back up in her left.  Surely strengthening the operative leg makes it feel more stable and trustworthy (for lack of better word).

So needless to say, Heidi is doing great.  I can't wait for her to be able to be "normal" again!  But we'll take it slow and ease her into more and more activity.  I cannot remember if I told you guys, but dogs who have cruciate ligament tears are more prone to meniscus tears.  The meniscus is a  cartilaginous cushion (if you will) within the knee joint.  The chance of a meniscus tear is not as great as the chance of tearing the second ACL after the first tear though... I think the doctors quoted us a 10-15% chance of meniscal tear post ACL surgery.  Much better odds than the 60+ percent we were warned of a second cruciate tear after the first.  So we're hoping we're in the majority and don't have to worry about any more tears!

Oh one other thing.  I did notice earlier this week Heidi had a loop of suture coming out of her incision site.  I was afraid that was happening because she kept licking her knee and it looked weird... almost the way an ingrown hair looks.  These sutures aren't the outer sutures that I removed after 14 days, but rather the internal sutures probably used to stitch up the muscle and other tissue under the skin.  These are supposed to dissolve on their own, but I know from experience working with vets, sometimes it takes a while.  So they appear to be working their way out.  I cut what I could because I was not able to pull them out.  They must be connected to other pieces, but I wanted to let you know this happened, so if it were to happen to you, you don't freak out!  I think it's normal (I did not consult a vet, but I've seen this before) so I'm not worried. 

Anywho, I just wanted to give you a quick update!  Enjoy your weekend!

Rehab Walks in Full Swing!

Well, we reached the 4 week post-op mark on Friday and began our walks.  Needless to say, Heidi was thrilled to venture beyond the "potty area".  This week, she gets two 5 minute walks every day.  It doesn't sound like much, but it makes a world of difference for her.  Gives her a chance to briefly release some of that pent up energy.  (She has a LOT of it!)

I would like to note that her limp is continuing to get better.  It's much much less noticeable when she walks- maybe just a tiny hitch in her step- although she still doesn't put full weight on it when standing still.  I do think that has improved a little since my last post, however. 

As far as aesthetics go, her knee looks all kinds of funky.  The wedge of bone they pushed out to make room for the titanium implant looks really creepy and uncomfortable, but obviously it's working because she continues to improve each week.  I'll just have to get over the bumpy knee.  I need to try to get a picture of it... I promise, it's really weird and creepy... more so when she is walking.  Oh well, whatever works!  Her other knee looks very different.  It's still bulkier than a "normal" knee, but in a different slightly less creepy way.

At this moment, Heidi is laying with head against the base of the couch couch looking under it (probably at a toy) and whining with her tail thumping against the floor.  Sorry neighbors :-/  Obviously we haven't burned enough energy today.  We are looking forward to our 10 minute walks next week! Until then, have a great week/weekend and I'll update again soon!

A Little Past 3 weeks

All smiles

This post is going to be boring, but I want to try to post every week for those people who are following along because they find themselves in the same situation we're in.  Heidi is doing great!  Nothing new to report, really.  I will say I think the past couple of days I've actually noticed a difference in her limp!  When she walks it's really not too noticeable, but she does still bear less weight on her most recently surgerized (left) leg when she's just standing still.  It is totally possible this is a result of the reduced muscle mass in that leg and not so much that she's in pain (I'm hoping that is the case at least).  I was checking out her legs this evening as she was snuggling in my lap and it is crazy how big her calf muscle is on her right leg compared to her left.  There's also a pretty noticeable difference in her thighs/glutes, too (ps. I have no idea if dogs muscles are named the same things as humans so use your imagination).  I can't wait to build those back up!  Starting Saturday, she gets to begin her rehab walks :)  We'll start with 5 minute walks twice a day, which will be a real treat to Heidi! 

My only other concern is that she is becoming more and more wild. Obviously her leg is feeling much better because she is reverting back to her wild-woman ways.  We've started giving her Tramadol less than 12 hours apart.  We still only give it twice a day, but I give it when she eats breakfast around 8, then again around dinner time at 5:30ish.  Last time, we began giving the Tramadol three times a day as you may remember, but I'm sort of against over-medicating and this seems to do the trick.

Well, that's enough for now, see ya again in about a week!

It's been 2 weeks

Just laying in Mom's lap

Well, we're a little past 2 weeks post-op at this point, and things are still going great.  Nothing much to report, but I do want to say Heidi is still limping.  I think it's getting better but I see her every day so it's hard to tell.  It's definitely better than when she first came home, though.  So I think slowly it is getting better.  I was starting to freak out a little (as I knew I would) because she still had a pretty noticeable limp, but I looked back in my posts from last time, and found that at 2 and a half weeks post-op I reported that she still had a bit of a limp, so I think we're on track.  Made me feel a lot better at least!  Oh, I did take out her stitches this past Wednesday.  Everything looked good and her incision seems to be healing nicely.  She was a little more difficult this time, but I put Alex at her head with a spoonful of peanut butter, while I clipped and pulled out the stitches and that worked like a charm. 

Well we're halfway through the first 4 weeks which is fabulous!  Heidi is pretty antsy at times, but she's been a good girl.  Her grandparents came to visit her yesterday and she was SO thrilled!  As I've probably mentioned before, they are her favorite people.  And I guess that's all I've got!  Except for a few pictures, of course!

Family snuggle time!

Dad bought her a new bone

Playing dress-up in Mom's necklace

6 Days Post-op

I just wanted to update very quickly before going to bed.  No major changes for Miss Heidi in the last few days.  She is still doing very well.  One thing to note, I haven't noticed nearly as much swelling as with the last surgery.  Some of you may remember her "jiggly cankle" as I liked to call it.  There has been almost no jiggly swelling this time.  Maybe it's because the surgery was slightly less invasive?  Who knows.  I have noticed it's much easier for her to get up and down.  The first couple of days, just laying down from standing and standing from laying down was quite the task.  Lots of funky positioning and balancing.  Now, she uses her operative leg much more making her more stable.  She also seems to be walking with slightly less of a limp, although it's hard to judge because I see her daily.  We ended her main pain medicine, tramadol, a couple of days back and got to increase the trazodone (her "calming" drug), but she's MUCH more active.  She is a maniac when I get home from work.  Forget tail wagging... it's more like full body wagging... for like 5 whole minutes.  But I sit down with her and we snuggle and she gets it all out!  Not gonna lie, that's probably my favorite part of the day.  Makes you feel good to be soooo missed!  Other than that, not much to report, thank goodness!  I'm going to take her out one last time then hit the sack.  Oh and tomorrow is Friday, so you know it's gotta be a good day! 

Post-op: Day 3 (again)

Well, I'm glad to report I really have nothing to report!  Heidi is doing really well so far.  She sleeps a lot (thanks to some wonderful medications!) and she loves to snuggle with Alex and I.  She's eating well and all's normal when it comes to bodily functions, so I'd say we're doing great!  The one thing I look back in my blog and wish I had talked more about is her limping.  I don't remember exactly how it progressed and really should've talked more about it because, of course, this time I have a feeling I'll be paranoid she's not doing as well as before, when in actuality, I probably just don't remember!  So for the sake of others in our same situation, I'll try to note the status of her limp in all my posts.  However, it's important to note every dog's recovery will be different so if you're also going through this, don't freak out if your dog's progression doesn't exactly mirror Heidi's.  From day 1 post op, she's been using her leg.  Not to it's full potential, obviously, but she does bear some weight.  I would say today she actually puts a little more weight on it than the past two days, although if she gets going too fast (bad dog!) she will skip that leg every few steps.  I took her outside an hour or so ago and we saw another dog. It was all I could do to keep her calm so I now know I need to keep her from seeing other dogs when outside. And I'll tell you what I really love about this whole thing... carrying my 70 lb dog up and down the stairs for potty breaks!  And in this heat!!! I'll really miss that the most when this is all over ;-)  Well, that's all for now.  I'll post again in a day or two.  In the mean time, enjoy some precious (if I do say so myself!) pics of "the Hiney"!  [*Just FYI, our niece used to call her Hiney before she could pronounce her name and it stuck! So that's one of her many silly nicknames]

First day post-op snuggling in mom's lap <3

Rear view: slight swelling and muscle atrophy and of course a POODLE HAIRCUT!

She did it again

Whelp, we were right.  Heidi tore her cranial cruciate ligament (same as ACL in humans) in her left leg, so we've gone to the vet school and just brought her home from her surgery.  I won't go through all the details, as everything was basically the same as with her right leg (which you can find in one of my first posts to this blog if you're new) but there were a few differences this time I'll tell you about.  We skipped going to our local vet this time and went straight to the vet school since we were fairly certain it was a torn ACL.  Our suspicions were correct, so they did X-rays in preparation for surgery.  This time, we actually decided to do a slightly different procedure called MMP (Modified Maquet Procedure).  It's a newer surgery, but it is really just a slight variation of the TTO surgery that Heidi had before.  It's slightly less invasive as they only had to make 1 cut into the bone, unlike the TTO that requires 3 cuts. This also shortens the length of the surgery a bit, making it a little cheaper since you pay for the anesthesia by the hour.  Instead of a titanium plate and screws, this time Heidi's hardware consists of a porous titanium wedge and wire.  The wedge acts as a filler to change the shape of the tibia, and because it's porous, the bone can actually grow in and around it as it's healing.  It's hard to explain how the surgery works, but here's an X-ray I found online so you can at least see what it looks like.



It's kind of hard to explain WHY this procedure is a good solution for a torn ACL, and I'm no expert but I'll try.  So the top bone you see is the femur, and the bottom bone with all the new accessories is the tibia.  The problem when a dog tears their ACL is that the knee loses stability.  The ACL attaches from the femur to the tibia, and without it, the femur can slide down the tibia a little because of it's downward slope, making it uncomfortable/painful for the dog.    The bone modification this surgery does changes the angle of the patellar tendon in relation to the slope of the top of the tibia.  (Just a quick anatomy lesson, the patella is the knee cap and the patellar tendon attaches from the quadriceps to the tibia running over the patella.)  Anyway, the thing to remember is that the angle between the tibial crest and the patellar tendon are of great importance in re-stabilizing the knee (the closer to 90 degrees the better), but I don't exactly know the full mechanics behind that!  I guess that's why the vets make the big bucks!

Anyway, now that I got all the complicated stuff out of the way, I'll talk a little about Heidi.  We picked her up at 8:00 this morning and she's pretty much been sleeping ever since.  I laid down for a nap next to her on the floor when we got home.  We snuggled up and I was able to get a little extra sleep- something I've been lacking this week!  She can walk pretty well and already puts a little weight on her leg just like last time.  Dr. Tuohy said this morning she thought Heidi was feeling "too good" so we will have to make sure she rests it.  As I might have said last time, keeping her quiet for 8 weeks will probably (hopefully) be our biggest challenge!  As with any surgery, there's always a small risk of infection and in her case implant failure, but the incidence of that is low and we will just hope for the best!

I did have a scare with her after we came home from the initial consultation and x-rays, and I should tell you about it because I was totally scared to death and freaking out like a crazy person!  So, she had to be sedated for x-rays- no big deal, she's had them twice before and was fine after both.  Dr. Roe (our surgeon) warned me that she would be a bit groggy probably until the next day and I was prepared for that as we had already been through this twice.  I brought her home and put her in her bed and went about my business.  It was about 6pm and I was starving so I went and grabbed some food then settled in for the night.  I noticed she was a lot more groggy than the last 2 times, but didn't think much of it because isn't that what sedatives do?

 By about 10:30, I was getting ready for bed and was trying to get Heidi up to go out one last time.  It took me FOREVER to wake her and it kind of scared me.  She also felt abnormally cool to the touch.  Then I started noticing she was taking a lot of time between each of her respirations, and being a nursing student I immediately grabbed my stethoscope to listen to her heart beat.  Because of the way she was laying it was kind of hard to hear it, but I thought it was pretty irregular and unusually slow.  So I took her pulse for a minute from her femoral artery, and got 39 beats per minute and it was definitely irregular.  That's when I freaked out.  If I remembered correctly, the average pulse rate for large dogs is 60-100 beats per minute.  Then I counted her respirations for a minute and got 7.  Again lower than what I was pretty sure was normal (maybe 10-20 range?).  I started to panic.  Alex was out of town for the night and I was convinced Heidi was dying.  I called my parents and ultimately decided to call the emergency vet.  I called the one at NCSU since they would have her records there, and they said someone would call me back.  After waiting an hour- the longest hour of my life, might I add- I finally called them again.  The receptionist, Sarah, was so nice and had just spoken with the doctor.  Apparently, one of the drugs they used to sedate her causes decrease in pulse and respirations and respiratory arrhythmia.  Whew!  Such a relief since those were the exact symptoms she was experiencing.  She told me if she was still like that in the morning I should take her to my local emergency vet. 

I felt a lot better and was EXHAUSTED from my anxiety attack so Heidi and I got in bed.  I still wasn't able to sleep well, because it seemed like every hour I would wake up and put my hand on her chest to make sure she was breathing.  Sure enough, when my alarm went off the next morning she popped up and was ready to go!  Here's the take home message from this story.  I should never have children--- imagine what a wreck I would've been if it was a kid?!?!  But who am I kidding... Heidi pretty much is my child and some might say I'm abnormally obsessed with her.  But I'm OK with that!

 I'll upload some pictures later. Time for another puppy snuggle!  This post was ridiculously long- sorry :)

Bad News at 6 Months Post-op

Well, it has been 6 months since Heidi's knee surgery.  All was smooth sailing until a couple of weeks ago.  I took Heidi to visit her "grandparents" (my mom and dad) and she was just hanging out with us on the porch, then all of the sudden she got a whiff of something and took off around the side of the house.  I ran after her and as I turned the corner, I saw her circling the bottom of a tree staring up at Callie, my parents' cat, who was perched on a branch up high.  I was terrified because we still didn't want Heidi running all wild and crazy, and at first I thought all was fine, but later that night Heidi was limping.

 I literally could not sleep for 2 nights... all I could do at night was think about her leg, the cost of another surgery, and just the overall emotional strain another surgery would put on all 3 of us.  I prayed it was something else... just a sprain or something, and actually the limping did subside, so we had hope.  But we're now thinking it was false hope.  Heidi is once again limping and it's getting worse.  This is exactly what happened with her first ACL tear.  She would limp and we'd force her to rest a couple of days.  Then it'd seem a to get better for a day or so but come back worse than before.  So, here we are.  I called the vet school today and made an appointment for July 11th.  I'm really dreading this whole process, but I just want her leg better.  Maybe we're crazy for forking out another HUGE chunk of money on her, but I can't imagine not doing it.  My birthday is in a week and I cannot think of a single present I want.  It seems so stupid to ask for material things when this is looming in our future.  I want my baby girl to be able to run and play again.  Can someone grant me that birthday wish?  Maybe the vets at NC State?  Sure they can... for a price!  The good news is that she only has 2 of these ligaments, so if we fix both, we're good, right?  One can only hope!

You know, it seems these types of things happen at the most inopportune times.  Don't get me wrong, things are going pretty perfectly in our lives (minus this little hiccup), but the scary part is that I'm about to start nursing school in August.  Which means I'm dropping down to working only 20 hours a week.  Which in turn means I'll only be bringing home half of my usual paycheck.  I will say though, we are still lucky. We have no debt and we have managed to save a little, so someone has been looking out for us.  I really just feel fortunate that we CAN opt to have this surgery.  Many, many people out there cannot make the same choice in these tough economic times.  And of course, I am truly so lucky to have a husband who wants this surgery for our doggie just as much as I do.  He loves his "girls" and would do anything for us, so really Heidi and I are the luckiest girls around!

Well, fortunately for you (maybe), you all can look forward to more blog posts in the near future.  I'll try to keep up with it and keep you up to date as things happen.  And like I have said before, I hope this blog will help someone else get through this situation, if they are ever faced with it!

Heidi and her friend, Levi

6 Weeks Post-op

Well, I've slacked off a little on my updates.  The good news is, there has been no bad news to report, so that's why I haven't posted in a while.  Friday marked 6 weeks after surgery and little miss Heidi is doing great.  Her limp is barely noticeable.  In fact, if you didn't know she had surgery, I don't think you'd notice the slight hitch in her gait.

laying in Dad's lap while he plays video games

 Since my last post, we did get the go ahead to increase her trazodone.  She now gets 200mg 3 times a day and it seems to have made a little bit of a difference.  We haven't had any more couch jumping, so that's always good.  We've also started going on walks twice a day.  Week 4 we did 5 minute walks, week 5 we did 10 minute walks, and this week, we're up to 20 minute walks.  Her first one was Saturday morning, and she LOVED it.  One of Heidi's favorite things is sniffing and when we're outside, she just can't get enough!

Beautiful day on the porch!

 Also yesterday we had our first bath since surgery.  The vet told us to keep her off slippery surfaces because if she slipped she could re-injure her leg.  Finally, I decided I'd had enough of her stinkiness!  I put a towel down in the bottom of the bathtub so she could stand without slipping and it worked like a charm.  No more stinky dog :)  It's funny... Heidi hates getting a bath but she loves being dried with a towel.  She gets so excited when I throw the towel over her and start rubbing her with it.  She prances all around just loving it.  It's really cute. 

I just set our final appointment at the vet school (assuming all goes well there).  We go for X-rays on February 16th and will hopefully get the all clear to begin working up to normal activities.  We still plan to take it slow so we can build back up the strength in her operative leg.  It seems all too often, dogs with ACL injuries tear their other ACL.  From the research I've done, I think this is because they are allowed to run wild and free before they have regained full strength in the injured leg.  If that leg isn't as strong as the other, they may still have a tendency to use the "good" leg more than the operative leg, putting more strain on the good knee.  That extra stress could cause another ACL tear which we honestly cannot afford!  So we must do everything in our power to prevent it! 

Well, that's all for now.  I hope everyone has a FANTASTIC week!  And as usual, here's one more precious picture!

Wearing my scarf and LOVING it!  Can't ya tell?